DEXCOM G5 Continuous Monitoring System

DEXCOM G5 is a 24/7 Continuous Monitoring System (CMS) that monitors your glucose level every 5 minutes. How does it work? There is a small, discrete sensor placed just under the skin that sends data via bluetooth to your smartphone or other electronic devices. You download an app from the Dexcom website that provide the data in vivid colors so you can easily see when your glucose is trending high, low or just right.

This is an excellent option for people who struggle to keep their glucose levels normal. The app sounds a warning if levels get too high or too low, so people with diabetes know when they need to take steps to lower or raise their glucose level. this also puts an end to pricking your finger several times a day to monitor your glucose level, which is one thing I really don’t like doing. The app also has a built-in user guide that includes video tutorials, a setup wizard, and  links for tech support. My wife can also add the app to her phone so she can monitor my glucose level as well. This is great when I am out hiking alone. She doesn’t have to worry about what my glucose levels are. Or if they are high or low at a particular time she then will anyway. But, at least she knows.

There are some things to consider. If you are using your smart phone,  iPad, iWatch or another electronic device and it goes dead, you cannot monitor your glucose level unit the device is charged. This may not be a great thing if you are not near a charger and your phone dies. the problem is that if you are using your smartphone or iPad sometime the data doesn’t get loaded. Maybe a glitch with the app? If you use the receiver that Dexcom makes to go with the monitor then you won’t have that problem but the receiver is sold separately so the smartphone is more convenient. That all being said, it is still a great device to have so you know what your glucose level is an any time. I found this for sale at Amazon.com for $175 plus shipping. It is a bit expensive but maybe your insurance will pay for some, most or all of the cost. You will need to call and find out. If you have one or buy one, send me a comment and I will post it to this website.

Can Exercise be Dangerous for Type 2 Diabetes?

The answer to this is yes, IF you do not manage your glucose levels. Dr. Ben Stutchbury, of the University of Manchester, states that exercise in patients with diabetes is very important but too much can be dangerous (The British Journal Of General Practice, August, 2016). This is due to hypoglycemia, or low blood sugar. Often times I work out in the yard and suddenly I begin to shake and feel faint. I head inside the house and check my glucose level and its below 50. I quickly drink a glass of orange juice then wait 20 minutes for my glucose level to return to normal (between 70 and 120). Then I go back out and work in the yard again. I try to prevent this from happening but sometimes I don’t know I am doing something strenuous until I am. For example, working in the yard. There are times when I do not intend to work in the yard. I go outside to check the mail and I see a weed in the flowerbed. So, I pull it. Then I see another one. Then another. Then I get the yard container and pull weeds. Then I am raking. Then mowing… Then my glucose level drops and I need to eat or drink something… quickly. Below are five steps you can follow to make sure you are exercising but not to the point that your glucose level drops below normal. These five steps have helped me tremendously.

  1. Check your glucose level before doing anything strenuous.

If your glucose is normal drink a glass of juice or eat a bit if candy before doing something strenuous. Don’t over-do it! A little sugar goes a long way. An 8-10 ounce glass of juice or a half of a candy bar may be plenty. You just need enough to get through the activity.

  1. Check your glucose level throughout the activity.

If it is starting to get low, eat or drink something. I check my glucose level at least four times a day. More if I am exercising or doing something more strenuous. It’s never a bad idea to check your glucose level several times a day. During the summer I often put on a backpack and hike 2 to 3 days in the Cascade Mountains along the Pacific Crest Trail. I check my glucose level every two to three hours to make sure my glucose is stable and I bring carbs with me incase My glucose level drops.

  1. Work with your doctor

Dr. Stutchbury states that “the risks can be minimized or completely avoided by doctors, nurses, and patients working together to construct a plan of diabetes management before, during, and after the activity.” Communicating with your health professionals is the best way to manage exercise and strenuous activities. Your doctor may advise you to take less medication if you know you are going to do something strenuous.

  1. Keep an emergency supply of carbohydrates close.

My wife has a container in the house with a supply of candy in it and we always have orange juice in the refrigerator. It’s only for me and I only use it when I need it. It is not there as a late-night snack. It is for emergencies. If we are running errands I take something with me. We often get side tracked so if my glucose level starts getting low I have something to tie me over until we eat.

  1. Control your diabetes. Don’t let your diabetes control you.

I often do strenuous activities. Sometime it worries my spouse. But I will tell you what I tell her: ‘I cannot let this disease control me or limit my life style. I will manage my diabetes so that it does not manage me’. I diet. I exercise. I monitor my glucose levels. I manage my diabetes so I can live a long, happy life.

Source: Stutchbery, Ben, Diabetes: The Danger of Exercise, The British journal of general practice: The journal of the Royal College of General Practitioners, 2016, 66, 649, 427-427, England

 

 

Type 2 Diabetes and Exercise

PHYSICAL EXERCISE THERAPY

Diabetes is increasing at an alarming rate globally and is the major cause of death related to cardiovascular disease (Lumb, 2014). Diabetes has impacted over 300 million people in the last 30 years and is expected to hit 600 million within the next 20 years (Bloomgarden & Li, 2015). These numbers are really an educated guess because there are many people who do not know they have this disease. This is mostly due to obesity and lack of exercise, although in some cases such as mine that is not the case. By exercising, people can reduce the risk of developing diabetes by 47% to 58% (Lumb), (Bloomgarden & Li). As a matter of fact, many clinical studies have shown that diet and exercise in pre-diabetes patients can slow the onset of diabetes, and improve the control of glucose in people with diabetes (Bloomgarden). Exercise for me means less insulin and other drugs, and I can eat a little more to keep hyperglycemia from occurring.

The American Diabetes Association states that adults with diabetes should perform at least 150 minutes per week of moderate-intensity aerobic physical activity (50–70% of maximum heart rate), spread over at least 3 days per week with no more than 2 consecutive days without exercise. That’s 50 minutes of exercise every two day. If you think about it, it is not really that much and you do not have to kill yourself doing it.  Remember, this is moderate-intensity or relative intensity. Not absolute intensity. Below are some of the positive effects of exercise and diet for people with pre-diabetes and type 2 diabetes;

·      Less medication

·      Reduction of sleep apnea

·      Enhanced mobility

·      Decreased urination

·      Reduced cardiovascular risk

The problem is that people with diabetes fail exercise while self-monitoring, mainly due to lack of motivation or poor health. There is research currently being done and being considered for approval by the Food and Drug Administration called Physical Exercise Therapy (Balducci, et al, 2014) and is designed for people with diabetes to help them get the exercise they need and provide support and help while doing it. Like a pharmaceutical drug prescribed by a physician or a restricted diet by a dietician, specific exercises would be prescribed with a therapist designed to help keep glucose levels at the desired levels while being monitored not just to make sure exercises are done but also to ensure they are done correctly and that no more exercise is done than the body can physically handle. The dose and intensity of exercise would be prescribed by a doctor in conjunction with the patient.

Physical Exercise Therapy would include:

Leisure time activities – Walking in the park, gardening, sports or dance, and formal exercise training.

Absolute intensity training to get the heart rate up if the patient can do this.

Relative intensity training. This is more like warm up training but designed for patients who cannot do absolute intensity training.

Exercise training such as cardiorespiratory fitness such as walking on a treadmill or other equipment to get the heart rate up.

Muscular strength and resistance training such as lifting weights to get back muscle lost due to high glucose levels.

Flexibility training to help work on joints for mobility.

Occupational physical activity so patients can do their jobs.

Conclusion

There is a long way to go for this type of therapy to work. Question such as payment for therapy by insurance companies and exercise facilities that would allow therapists and patient to work together on exercise equipment would need to be answered.  Also, would patients need to be in therapy long term or short term with the hope that this type of therapy would eventually pave the way to self-monitoring? Cost is most certainly a factor. Clearly, fiscal exercise therapy would be helpful for the control of glucose levels in patients with type 2 diabetes.

When more information becomes public regarding physical exercise therapy it will be posted on this website. Stay tuned!

References:

Balducci, Stefano, et al, (2014) Physical exercise as therapy for type 2 diabetes mellitus: Exercise as Therapy for Type 2 Diabetes, Diabetes/Metabolism Research and Reviews, 30 (S1) Retrieved from http://el2ne5ae7f.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Physical+exercise+as+therapy+for+type+2+diabetes+mellitus&rft.jtitle=Diabetes%2FMetabolism+Research+and+Reviews&rft.au=Balducci%2C+Stefano&rft.au=Sacchetti%2C+Massimo&rft.au=Haxhi%2C+Jonida&rft.au=Orlando%2C+Giorgio&rft.date=2014-03-01&rft.issn=1520-7552&rft.eissn=1520-7560&rft.volume=30&rft.issue=S1&rft.spage=13&rft.epage=23&rft_id=info:doi/10.1002%2Fdmrr.2514&rft.externalDBID=n%2Fa&rft.externalDocID=10_1002_dmrr_2514&paramdict=en-US

Bloomgarden, Z. & Li. X (2015) Healping People with Diabetes to Exercise. Journal of Diabetes, 7(2), 150-152. Retrieved from http://web.a.ebscohost.com.contentproxy.phoenix.edu/ehost/detail/detail?sid=070092e7-a9ab-4df6-af89-556d961dac63%40sessionmgr4006&vid=0&hid=4214&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=100696491&db=a9h

Lumb, A. (2014). Diabetes and exercise. Clinical Medicine, 14(6), 673-676. Retrieved from https://search.proquest.com/docview/1635285524?accountid=458